Varying degrees of anxiety

Kari Swanson

That little flutter in your stomach when you are entering a room full of people, is that anxiety? It is if that flutter turns into a mountain lion of emotion that causes you to run from the room and back to your safe place.

We have all experienced varying degrees of anxiety in the forms of worrying and nervous behaviors. Some people, more than you probably realize, experience anxiety in its most extreme forms of panic attacks, flashbacks, nightmares, chest pains, etc. The ultimate inability to function is at the core of clinical anxiety. The different anxiety disorders are Generalized Anxiety Disorder, Social Anxiety, Specific Phobias, Panic Disorder, Obsessive Compulsive Disorder, and Post Traumatic Stress Disorder.

Social Anxiety Disorder and Generalized Anxiety Disorder are the top two anxiety disorders people experience.

Social anxiety, intense anxiety or fear of being judged, negatively evaluated or rejected in a social or performance situation is reported to affect 15 million adults or 6.9 percent of the U.S. population. People with social anxiety disorder may worry about acting or appearing visibly anxious (e.g., blushing, stumbling over words) or being viewed as stupid, awkward, or boring. Social anxiety typically begins around age 13 and, according to the Anxiety and Depression Association of America survey, 36 percent of people with social anxiety disorder report experiencing symptoms for 10 or more years before seeking help.

Can you imagine feeling so paralyzed with fear of leaving your house or being around others that you don’t seek help for 10 years? That just acknowledges the amount of stigma associated with mental health, in general, let alone anxiety.

Generalized Anxiety Disorder is reported to affect approximately 6.8 million adults, about 3.1 percent of the U.S. population. People experiencing Generalized Anxiety Disorder feel anxious on most days and worry about lots of different things for a period of six months or more. The response from most people with Generalized Anxiety Disorder, when asked why they feel the way they do, is “I don’t know.” Honestly, they may really not know. This is a very difficult thing for someone struggling, as they feel judged by others for not knowing what is making them nervous or why they are worried about their plans for the following week, month or year.

Specific Phobia Disorder is when someone is intensely fearful about a particular object or situation and goes to great lengths to avoid the object or situation such as having injections or traveling by plane. Some common phobias are small spaces, spiders, and snakes. The intensity of the anxiety is seen when the object or situation feared is talked about or seen. It can also present when the person thinks about the object or situation.

Panic Disorder is when someone has been experiencing recurrent panic attacks or persistent fears of having a panic attack for more than a month. A person experiences intense overwhelming and often uncontrollable feelings of anxiety combined with physical symptoms such as shortness of breath, chest pain and/or dizziness. Many people think they are experiencing a heart attack. The fear of having a panic attack in public creates a level of anxiety in some people that then prevents them from going out in public. When someone experiences a panic attack, it often brings feelings of loss of control, embarrassment, and shame. This is why the mere thinking of having another panic attack when in a public setting, such as a restaurant or at work, brings on intense fear and is enough to limit the person’s functioning capabilities.

Obsessive Compulsive Disorder (OCD) consists of unwanted and intrusive thoughts and fears that cause anxiety. A person with OCD tries to relieve his/her anxiety by carrying out certain behaviors or rituals such as hand washing or cleaning excessively due to fear of germs.

Post-Traumatic Stress Disorder (PTSD) occurs after a person experiences a traumatic event (e.g., war, assault, accident, disaster). People with PTSD experience nightmares, intrusive thoughts and flashbacks of the traumatic event consistently for at least a month in duration. Smells, noises and anything else familiar to the trauma experienced can intensify the amount of anxiety a person feels. People with PTSD attempt to avoid anything related to the event in order to decrease the amount of anxiety associated with it.

When asked in a study of people who have experienced anxiety, what anxiety feels like, some of the answers were:

“Wearing a corset. Your chest is too tight, it’s hard to breathe and your stomach hurts. You are uncomfortable in your own skin. You seem stiff and awkward to others.”

“Being inside a kaleidoscope. The world is too bright and everything keeps changing. As soon as you figure out the pattern, it shifts.”

“Being on stage ALL the time and you don’t know your lines.”

“Having a million post-it notes in your brain of things to do and not do and things you wish you hadn’t done. Notes are rarely thrown away, but new ones are always being layered on top.”

Can you relate to any of the above or have a loved one that this describes? If you don’t experience any of the above, imagine that you do. Building up our compassion and understanding for those that struggle with mental health issues is truly needed in our world to help combat suicide, bullying, and negative judgment. Sometimes, knowing what NOT to do as opposed to what TO do is more important. In most cases of anxiety, saying statements like “you’ll be fine once you get there,” “you are worrying about it way too much,” or “don’t think about it anymore” tends to cause more anxiety for the person experiencing it. Statements such as “what can I do to help you?” “if you need to leave, tell me,” or “let’s listen to music or play a game to get your mind distracted” help to validate the person’s feelings and to lend support in a comforting way.

Anxiety does not have to have a reason to be present, however, there are triggers that can present that allow a person to know that he/she may experience some anxiety symptoms as a result of that trigger being present. Anxiety triggers can be different for each person, but many triggers are common among people with anxiety. Most people find they have multiple triggers, however, anxiety attacks can be triggered for no reason at all. It is important to discover any anxiety triggers that you may have as an important step in helping to manage them. Knowing your triggers can help prevent the intensity, frequency, and duration of anxiety symptoms if you plan for the trigger to be present and have coping skills ready to use. For example, someone who fears being snuck up on my plan to have their back to the wall at most places in order to be able to see what is coming in front of him/her. Someone whose trigger is loud noises may always carry earplugs with them for when loud noises present. Planning and preparation do help to combat the intensity of the anxiety and more importantly helps the person experiencing it know that there is a plan in place. This is where being able to share your experiences with anxiety comes in. If you are able to explain some of the difficulties you experience with someone you trust, that person is then able to help you and support you when the anxiety presents. They can sit with you and help you remember to breathe, help you use some of the grounding techniques stated below or assist you with getting out of the situation if it becomes too much.

Some of the symptoms of anxiety are the common ones of stomach discomfort, headaches, overthinking and sleep issues. However, there are many, many other symptoms such as worrying about future events, feeling disconnected from the world, second-guessing yourself and others, hyperventilating and wanting and needing reassurance for every little thing you attempt to accomplish. People experiencing anxiety may exhibit some similarities in their thinking patterns. All or nothing thinking is the failure to bring together both the positive and negative qualities of the situation. Instead, a person with anxiety tends to exaggerate the negative as “always” occurring. Statements such as “I’m a failure”, “She’s perfect”, “I never do it right” are examples of an all or nothing thought process. Such statements increase a person’s anxiety over the situation and also allows for depression to build. To help yourself or someone you love who makes such all or nothing statements begin to rephrase the statement. If someone says “I’m just plain stupid” when attempting to do a task and not succeeding, the rephrasing of this could be “I don’t seem to be very good at this task like I am with math, painting, building, etc.” This helps to focus on strengths and less on the negative.

A technique that has helped many people with varying anxiety symptoms is called grounding — a technique that helps keep someone in the present and helps to reorient a person to the hear-and-now and in reality. These skills can be helpful in managing overwhelming feelings or intense anxiety by helping a person regain their mental focus from an intensely emotional state. These techniques work great with children also. The most common grounding technique is taking inventory of your environment and naming (out loud or in your head) five things you see, four things you can touch, three things you hear and one to two things you smell. This forces a person to get out of the state they are in and come back to the present. This helps to break up the thinking that is causing anxiety. Some other things to name would be the number of windows in the room, the number of electrical outlets, colors you see in the room and all the TV shows or shapes you can think of. There are sensory techniques that work great, too. These can be hot balls, lemon heads, sour gum, sour candy or anything else that provides a jolt to your mouth. Ice cubes work in the mouth or holding them and music is also a great sensory technique.

If you are in a situation and you start to feel anxious, the next step is usually your thoughts will turn negative and begin to spiral your anxiety feelings. Using sensory techniques allows you to take a break from your mind and focus on something mundane like the hotness in your mouth or the coldness in your hand or the music in your ears. I think the biggest thing sensory and grounding techniques provide a person with anxiety is control. Anxiety has a way of making someone feel controlled by the anxiety and that is a very helpless feeling. Using these techniques allows a person to feel they can break up the negative thinking and anxiety feelings, even if just for a couple of minutes. This helps to build a person’s confidence that they can control the anxiety and makes using these techniques part of their routine.

Anxiety really can feel debilitating and I call it the silent monster because you really do not know who is experiencing it and struggling through it. Be kind to yourself and kind to those that you know struggle. Don’t judge someone’s actions or behaviors since you don’t know what is driving them. Don’t think someone can do better than they are. Help them. Help yourself. Seek treatment if needed. Don’t struggle in silence.

Kari Swanson is a Master’s level clinician with 25 years of working in the mental health field. She is the founder of CORE–Choosing Openness Regarding Experiences which is a non-profit organization with the mission to provide mental health awareness and suicide prevention education to Warren County.